Is There a Norwood Class 2V?

Dr. Rassman,

Thank you for your very informative blog. I have a question about the pattern of hair loss. I am a 26 year old white male with a normal hairline, and a thinning crown. My father has suffered a similar kind of hair loss: His hairline hasn’t receded, but he has a bald patch in his crown about 2.5 inches in diameter. However, it seems to me that the Norwood scale indicates that MPB always involves some frontal loss (receding hairline), and that frontal hair loss usually precedes vertex hair loss.

So my question is: Is there a such thing as a Norwood 2V pattern (no frontal hair loss, but a balding vertex area)? If not, how is this kind of hair loss assessed/dealt with?

My hair loss was similar to your description, with progressive crown loss and no frontal loss, but Dr. Norwood never defined a Norwood 2V entity in the published classification system we see everywhere. The hair loss can be treated with medication (Propecia and/or minoxidil), and surgery is likely a possibility if the medication doesn’t work as well as hoped.